Internal Medicine

0521779407-10 CUNY1086/Karliner 0 521 77940 7 June 7, 2007 18:40

834 Influenza Influenza, Avian

differential diagnosis

■Common cold – generally influenza has higher fever/sicker with

influenza

■Croup

■Bronchiolitis

■Viral pneumonia

management

■Influenza vaccine should be given to high-risk individuals before

influenza season starts.

■Yearly vaccine needed

■High risk

■Antiviral drugs may play role in outbreak settings

specific therapy

■Amantadine/Rimantadine –Note: CDC recommends against using

currently due to documented resistance

➣Decreases severity if administered within 48 hours of illness

➣Not active against influenza B

➣Generally amantadine has more side effects than rimantadine

(lightheadedness, insomnia, loss of balance, especially in elderly)

■Neuraminidase inhibitors: Zanamivir (Relenza): inhalation drug;

Oseltamivir (Tamiflu): oral drug

➣if started within 30 hours after onset, can shorten duration of

symptoms and decrease incidence of complications

➣effective against both A and B

follow-up

n/a

complications and prognosis

■Reyes syndrome in children, particularly in children given salicylates

■Fatal viral pneumonia

■Secondary bacterial pneumonia

■Exacerbation of respiratory and cardiac conditions such as asthma,

heart failure, and COPD

Influenza, Avian.....................................

SUSAN PHILIP, MD, MPH

history & physical

Note: Please refer to the CDC website for the most current epidemiology

and management. http://www.CDC.gov